Breastfeeding Rant...

[artisanroast]

Hi,

I am generally in a bad mood today which isn't a great start, hence the rant...

I am a breastfeeding mother. I have had a little difficulty with breastfeeding, starting with having a prem baby who had expressed breast milk. We then achieved success with breastfeeding (hurrah!) and my daughter now happily feeds directly from me. I am feeling quite pleased with us and our progress.

However, this is my complaint... Any time it has become a little challenging e.g. the 6 week growth spurt or she has woken more often during the night or I haven't expressed enough to get a glass of wine (bad mummy for wanting one to start with!) I have lost count of the number of relatives, friends and health professionals who have told me there is no shame I giving her a formula bottle. I shouldn't feel bad if I have to bottle feed with formula. Formula will give you a break to get some sleep they say... And the examples continue...

Why is it that formula bottle feeding mothers feel they can pressurise to formula feed however God forbid if a breastfeeding mother pressurised a formula feeding mother to breastfeed?

Have the tables turned?

Even my husband got in on the act - but I think he was just after a less tired wife and possibly his old drinking buddy back!

The other thing that really pisses me off is if I gleefully accepted the advice to give an odd bottle because my milk supply 'may be a bit low' that would be a self fulfilling prophesy as the less my boobs are stimulated, the less they produce.

I chose to breastfeed to give my baby good nutrition and pass my immunity to them via my breast milk. I am quite determined that I will breastfeed or give my baby expressed breast milk even if it near kills me doing it!

So, rant over but...

Please if you bottle feed don't tell me to do the same.

YY Bird.

Ahh yes,

I understand, I had this from every angle too.

I was steadfast, while smiling sweetly, nodding with them all, the voices in my head were saying "why not fuck off to the farest end of fuckdom with your views and advice, oh and fuck off some more on your way back"
They all shut up eventually when I carried on merrily and happily.

I now have it again as...SHOCK HORROR I am still happily bf ing my 2.5 year old toddler. The few that know are actually horrified.

Fuck em I say, I'm a tired old bird, not to be crossed, too long in the tooth and too set in my antisocial ways now, I just think that at 45 years old, no one is telling me what to do....unless they fancy a scrap!!!

Chin up chuck, fuck em

53rd I think if HCPs asked people what they wanted it'd be a start. Not in an abrupt way, but some gentle questioning would help to highlight whether a mother wanted to introduce formula (for example).

It's such a difficult subject for everyone involved to discuss because until you get into it you don't know the motivations of the person you're talking to about it.

One of my closest friends had her baby and really struggled - BF hurt and her DD was windy and colicky and had terrible reflux. So she spent a huge amount of time expressing so she could mix the bottle with whatever the baby was taking for it, and she ended up with PND (and exhausted) over it. It was only when she went to her GP and they said, quite gently to her, that she'd done fantastically and there would be no harm in giving her baby some formula that she felt like she'd been given 'permission' to stop - in leafy affluent SW London where she lived there was an assumption that you would try to move heaven and earth to BF because that was best, so all she got was positive comments about how well she was doing - despite the fact that she felt like shit because of it and wasn't enjoying motherhood at all.

Incidentally, my MW told me that if I was still sober enough to hold the baby, I was sober enough to breastfeed them, no need to pump and dump ;)

I agree, Burrito - it's just good care and communications, isn't it?

Women can feel very conflicted with regard to feeding. They may want to struggle and to keep breastfeeding going and they may want to think about using formula....it's up to a good listener, an HCP or whoever else, just to be open and to listen.

However, I sometimes hear from women who say 'I was having so many problems breastfeeding, and I now wish someone had suggested formula, but instead they kept on and on trying to help me breastfeed'...and that's not fair, either! People can listen, but generally speaking they cant read minds :)

Having said that, it is always worse than useless to tell a woman 'just persevere' without actually exploring ways of relieving the problem :(

X posted with you, LBO :)

The mum you describe - very hard for the people around her to know what to do. If she is asking for help with bf and showing by her behaviour she is still prepared to struggle, then encouragement seems in order, rather than 'permission' to stop. A skilled listener makes it possible for a mother to explore her options without fear of judgement - and where this mum's 'cheerleaders' went wrong was not giving her space to do this. I am not generally in favour of HCPs or anyone else giving mothers 'permission' - a better way of helping is to enable the mother to reach her own decision knowing she will be supported whatever it is.

Some really good thoughtful posts on this thread - nice to have a discussion without it turning into a bunfight!

focus raises an interesting point, and one I've been thinking about a lot since I found I was pregnant - why is there so much vitriol and guilt about everything to do with parenting? Genuine question - I've been stunned at the amount of 'establishing my experience is more worthy' type crap on the web. Bf v bottle/attachment parenting/cry it out etc... An extreme example is a Facebook site saying c sections 'aren't really giving birth' (wtf?? So I'd have been a good mum to let me and my baby haemorrhage to death? Okeydokey...)

Where does this come from? Why are we so rabidly attached to rigid parenting styles?I'm wondering if there's a link with leaving work and temporarily losing our identity and importance as members of working society? Any other guesses? Social media pressure? Is it cultural?

Just to skip back to the pp who asked how hard it is to control for wealth. Controlling for wealth per se is easy enough - household income is measurable. The issue is how that relates to parenting and you get problems if you assume social status = parenting status (which alas is still an attitude in some circles.) My family were as poor as church mice growing up, but we had a house full of books and education obsessed intelligent loving parents. A study that assumes poverty = poor outcome would have put us in the wrong category. It's immensely hard to objectively measure the 'quality of environment" a child grows up in. How can you measure nurturing? You can't really, so other, perhaps inaccurate, measures are used and thus we have our confounding errors.

So yes, breast probably is best, but proving it objectively isn't easy, which implies it's not a big effect in western society. The mathematical power of a study of this type will always be low unless n= very large number. I worked on a trial a while back that needed tens of thousands of patients just to establish non inferiority of the drug under test. Not that it was better than the control drug, just that it wasn't inferior (the study was designed this way, to have sufficient power we needed a massive population.)

Anyway, my take on this is that education, information and support is key. Good breastfeeding counsellors are an incredibly valuable resource for mums who want to carry on but are struggling. No one should be made to feel guilty about how they feed their baby (unless they've got a bottle full of Coke and liquidised cheeseburgers on the go...)

More information
More support (for both ff and bf)
Less judgement.

So yes, breast probably is best, but proving it objectively isn't easy, which implies it's not a big effect in western society.

But researchers do manage to get statistically significant results on this, despite a small n.

I wonder if it would be easier to isolate the effect of breastfeeding from those unmeasurable confounding factors by comparing the outcomes of those who breastfed to those who wanted to breastfeed but couldn't. Although then I suppose you would have to assume that "success" at breastfeeding wasn't correlated with any of the outcomes you were interested in if you wanted to extrapolate to population level.

Although I'm not sure further research is all that important at an individual level. But maybe at population level with limited healthcare resources.

I think my dp struggled a lot with the whole "giving permission to give f" thing. Ds was born with a tt and bf was incredibly painful, big cracks in my nipples-it was agony. There were a couple of times when dp just had to leave the room when he couldn't watch me feed him again (I didn't know at the time-he's told me since)-he couldn't watch me cry and stamp my feet and cling to the furniture. He's since said that he was desperate to just tell me to give ds some f and he was very relieved when a mw said we should.

Skiptonlass- These bun fights only exist on line! In my experience most people don't really care how you feed your baby/where they sleep etc. By far the most pressure to bf ds came from myself-I'm not really sure where that stemmed from.

Op-I find it quite hard to listen to some comments about bf. I've chosen to mix feed dd (4 months) so she has a bottle of f a day. My MIL has said things like "At least you know she's getting a bit of something at least once a day then and "That's good- they need something proper when they become more alert". I know logically that she's talking nonsense but I have very little confidence in my ability to bf my baby and it doesn't help.

It's probably best if people just kept their noses out unless asked specifically.

sweetadeline so technically 'an intention to treat' study? Interesting... :)
As you say, it's finding a direct measure that's difficult!

tiktok hits the nail on the head above - asking what the mother wants the desired outcome to be is key to giving support.

Skiptonlass, don't confuse internet ramblings and boasts and posturing for real life :)

In real life the 'mummy wars' don't exist - except in the sense that there are twattish people everywhere, if you look for them. Even online, these supposed wars are a tiny part of the more generally supportive, info-sharing that characterises mothers talking to mothers.

Even here, a thread like this, which is respectful, open-minded and non judgmental is far more typical than anything which leaves blood and tears all over the carpet.

Of course you are right that 'proving' health effects of formula/breastfeeding can't ever be done in the way you might do with drugs and an RCT (even then, 'proof' is not possible once you move away from lab rats in a controlled environment and include real life humans in your tests). But if you are interested, look at the links I sent. It's not at all scientific to say, as you did, that because proof is not forthcoming, the effect is not big. I expect you might want to think again about that!

There are a number of measures of nurturing, by the way. Some of the breastfeeding literature controls for them.

Adeline there are studies which look at intention to breastfeed, and separate it from actual breastfeeding. Just recently a study doing exactly that found intention to breastfeed, followed by no/little breastfeeding, was a risk factor for pnd.

There is a rich infant feeding literature, and I get a bit tired of the old trope that we have very little idea of health effects in the west, because the researchers are somehow unaware of the need to control for a host of variables. It's just not true.

I read recently that it was double Tiktok- that wanting and intending to bf and then not being able to doubles the risk of pnd (compared to wanting to bf and doing so). I think it was the Times reporting on the study.

I read quite a lot about the benefits of bf when i had ds, essentially looking for a study that said ff was just as good to try and make myself feel better about mix feeding. I didn't find one although I do think that some of the benefits are marginal. I think sometimes it's the gap between expectation and experience which is so hard to take. I should have prepared myself better. The nhs 10 minute talk with a wollen boob was, frankly laughable.

Nicky, read these:

www.sciencedirect.com/science/article/pii/S1876285914004318

link.springer.com/article/10.1007%2Fs10995-014-1591-z

First is a US study; second is a UK one.

The UK one is available in full. It links depression in pregnancy with depression after the birth - as a number of studies do - and controls for this alongside looking at breastfeeding intention and experience:

"Our most important finding relates to the
majority of mothers who were not depressed during preg-
nancy, and who planned to breastfeed their babies. For
these mothers, breastfeeding as planned decreased the risks
of PPD, while not being able to breastfeed as planned
increased the risks."

The are some health effects of infant feeding which are less powerful than others, for sure. I think the effect on maternal-infant relationship is marginal , to take one example - it's far more important to have a responsive, nurturing approach than what sort of milk the baby has. And some effects only come into play if they co-exist with other risk factors - I'd put obesity in that category.

But there are others which no one seriously argues with - infections, notably ear, chest and gastro - and for which the precise mechanism is understood. You have to remember that none of this is anything like predictive for an individual and that breastfed babies still get ill - they just have fewer infections, overall, than formula fed babies. But on an individual level, of course you can have formula fed baby A who never has an earache, diarrhoea or wheeziness, and fully breastfed baby B who has the lot, several times over.

I'm EBF because it's so much easier for me. Can't face fighting steriliser, measuring etc in the middle of the night. With the choice of cake (DD is very reactive to egg in my diet) or stuff it and give formula I consciously prefer the faff reduction of breastfeeding. No judgement on others' choices just respect that they can deal with the faffiness which I've discovered through expressing.

I already carry enough paraphernalia to sink a battleship without adding feeding kit to the load!

It's interesting isn't it Tiktok If it all comes down to finance, which let's face it, it does, there will surely be a tipping point at which supporting women who want to do so is more cost effective than treating women who suffer after not being able to bf?? I know I've mix fed both of my children but still think of bf ds as my failure and bf dd as my choice.

The bonding and nurturing was the aspect I've always been most about. I also think that the IQ increase might be more environmental too.

I think, returning to the op's point that there's so much ignorance surrounding bf it not only makes it harder for women to bf but also to make the decision to bf- I'm totally including myself in this! When I made the decision to bf ds I did so on no knowledge whatsoever. Knowing the reality might make it easier to manage expectations.

I've encountered (not UK, but similarish culture) a lot of suspicion of the ability of bf to nourish a baby properly. I'm on baby no. 3; I've had small babies and in two cases slow gainers, though perfectly healthy. One doctor even told me my dd was gaining 'too' slowly because I was feeding her too much - with ds1, my first child, I was whipped up into an awful tizz* by HCPs demanding I test weigh before and after feeds and threatening me with 'having to' return to topping up (after we'd got past that at 4 weeks) if he didn't gain something extremely specific like 28g a day. When I was expecting ds2 and feeding ds1, I was told ds2 wouldn't get any colostrum if I didn't stop. (I didn't, and tandem fed for a couple of years). I think there is something about the 'default feeding method' status formula acquired during the middle decades of the last century that makes it seem somehow more trustable than bf, despite all health and awareness campaigns.

I bf my first for 4.5 years, my second for 3 and am now 6 weeks in with my third. After the start I had with ds1, there was a lot of defiance and bloody-mindedness in my determination to carry on for as long as they wanted. Another reason - agreeing with the poster above - is 'faff reduction', definitely. I found bf a bit the path of least resistance in terms of it being an easy way to comfort the baby/child. Obviously, not having ff at all beyond week 4 of ds1's life, I don't know what it would have been like otherwise, but I tend to think that the sense of being in sync with them at night (we use/d bedside cots), and their robust immune systems, may have been promoted by the bf.

*tiktok - that was over a decade ago now, and you and mears helped me (under another name back then) immensely. I haven't forgotten it. Thank you

When I first had DS I had five family members who were very against me breast feeding and there little digs and comments were far from helpful. They tried to cover their judgement by making out that giving formula would be better for me or for baby because....(and then give lots of stupid reasons). They cloaked their disdain in my feeding choices by fake concern for me or DS's welfare.

DS was EBF until 6 months and and now at 20 months old he is still breast fed at least three times a day.

I know that formula isn't poison but to say breast milk has no real benefit/no superior quality to formula after the baby is a few weeks old just can't be right.

The biggest barriers I find to mothers who want to BF but are struggling are, tongue tie and early term babies getting jaundice. The guilt these women put themselves through for failing their children is written all over their faces when they come to our support group as well as their tears.

If our NHS is serious about improving BF rates and yes reducing the depression that failing to BF can cause they would correct tongue tie at birth like midwives used to do pre formula. In our area we have one 2 hour clinic we send mums too for tongue tie to be corrected. How many mums give up before even really starting because of tongue tie. I read somewhere 1 in 10 babies have some kind of tongue tie.

We should be educating mums-to-be about common BF problems instead of just extolling the positives. I try to do this with any mums-to-be so they don't feel like failures if it doesn't go to plan.

Someone up thread said formula is not poison well it is to a baby intolerant to cows milk! So don't assume formula will always magically solve a BF problem. People should not give unqualified advice.

I had the opposite experience too. Midwives, health visitors and family told me to persevere when trying and failing to breastfeed was bringing me to my knees and I was on the verge of PND. And when I did switch to formula the reaction was so harsh I fed him in tears.

And my baby didn't have tongue tie or anything else. I'd had a c section and have large breasts and nobody told me that crying was a late hunger cue so I struggled to get him to latch.

Cupofboo, yes you are right. I think a lot of HCP have no clue about the mechanics of BF. They naively assume you stick baby on the boob with some kind of magic. That is why antenatal education is important. As well as early feeding cues, the other is that new mums who have no experience of BF are shocked to find it takes a lot of small frequent feeds at all hours of the day in the first few days/weeks to get milk properly established. They think they don't have enough milk and they are doing it wrong.

You're right about the long-lasting feelings when bf does not go well, captain , but checking for tongue tie at birth is not the way to go - we'll just end up with a ton of unnecessary intervention. The thing is, we dont yet know enough about tongue tie. Some babies appear clearly tongue tied and breastfeed just fine - the research on this shows there is very little consensus about what sort or what severity of TT actually needs treatment.

I had a really similar experience CupofBoo.

Despite the fact that lots of people seem annoyed by the suggestion that they should do anything other than breastfeed, I would definitely gently suggest it to friends or at least tell them I found it really difficult (essentially 7 weeks of feeling very depressed, hourly pain when feeding, crying baby who wouldn't sleep) and that switching was such a life changer for me but most importantly my lovely baby. Anyway, ultimately we are all trying to raise happy and well-rounded lovely people and I think ff/bf has very little to do with that - well done all Mums!

Having tt snipped isn't always the answer either though. Dd2 had hers done at 2 weeks and hasn't been consistently back on the breast since. I'm currently expressing but will give it up soon as it's too much of a faff and l have done it for a few months so feel I've done my best.

However as dd1 was breastfed until 8 months l have had to reconcile the guilt of 'giving up breast milk early ' for dd2.

Correcting tongue tie, doesn't require much intervention. What are the risks of having it corrected compared to benefits?

People do BF with TT babies but it can be tricky to maintain a good latch, and it can be painful.